| NPI | 1023151644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 4822810-1205) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 43392) |
| 207L00000X Anesthesiology (Licence: KY 43392) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 13878) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2023-03-29 |